Integrated Care Management Program Manager at Seattle

Job Description

Integrated Care Management Program Manager
Seattle, WA; Tacoma, WA; Burlington, WA; Portland, OR; Lewiston, ID; Salt Lake City, UT
Telework may be considered for individuals residing in Oregon, Washington, Idaho or Utah ONLY

Bring your clinical background and program management expertise to this role where you will provide leadership and support related to clinical program evaluation, development and implementation for an integrated care management program supporting our MedAdvantage population. This role will focus on new and unique ways to engage our members to take an active role in their healthcare and improve health outcomes.

In this role, you will oversee the implementation of new clinical programs and the enhancement of existing programs delivered internally, and in collaboration with partner organizations and vendors. Working collaboratively with internal clinical leaders and staff, vendors, vendor management and numerous departments within the company, you will achieve excellence in implementation of new or enhanced program offerings.

Minimum Requirements

• Ability to evaluate program effectiveness, identify issues and opportunities, and work to continuously improve programs offered.
• Knowledge of statistics, data collection, analysis and data presentation.
• Strong communication and facilitation skills, including the ability to resolve issues and build consensus among groups of diverse stakeholders.
• Demonstrated competency in project management including ability to lead complex implementations with cross-functional teams.
• Knowledge of health insurance industry trends and technology.
• Expertise related to clinical case management and utilization management practices.
• Extensive knowledge of CMS and state regulatory requirements and demonstrated ability to manage compliant operations. URAC and/or NCQA accreditation and HEDIS and/or STARS experience preferred.
• Experience with geriatrics, Medicare, or MedAdvantage
• Normally to be proficient in the competencies listed above, the Clinical Program Manager would have Bachelors Degree in Nursing or related field, 5 years experience in area of focus (e.g. care management) and at least 3 years management, program management experience or equivalent combination of education and experience. Masters degreepreferred.

Required Licenses and Certifications:

• Current RN license, in a state or territory of the United States, preferred
• Certification as a case manager from the URAC-approved list of certifications preferred

Job Requirements

Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. A drug screen and background check is required.

Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. Weve been here for members more than 90 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.

If youre seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambias portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.


Country: USA, State: Washington, City: Seattle, Company: Cambia Health Solutions.